Safeguard
Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
CLAIMANr S
NAMEAND
ADDRESS
Safeguard
15 Manchester Road
Poughkeepsie, New York 12603
Due on Receipt
TERMS
Purchase
Ordar No.
DO NOT WRITE IN THIS BOX
Date Vouchar Received
FUND - APPROPRIATION AMOUNT
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TOTAL $0 00
ABSTRACT NO. I
VENDOR'S
REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
11/23/2009 25596730 1.00 500 Safety Paper $125 00 $125 00
TOTAL $125.00
John C. Masterson 12500
I, certify that the above account in the amount of $ .
is true and correct; that the Items, services, and disbursements charged were renderad to or for the municipality on the dates stated; that no part has been paid or satisfied; that taxes, from which the
municipality is exempted, are not included: and that the amount claimed Is actually due
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SIGNATURE
(SPACE BELOW FOR MUNICIPAL USE)
1- CJ4.o9
DATE
Town Clerk
TITLE
DEPARTMENT APPROVAL
The above services or materials were rendered or
furnished to the municipality on the dates stated and the
charges are correct
DATE
AUTHORIZED OFFICIAL
APPROVAL FOR PAYMENT
This claim Is approved paid from the appropriations indicated above
DATE
COMPTROLLER
~ SAr-EGUARD.
INVOICE
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025596730
Page
1
JEROME MARTIN
15 MANCHESTER ROAD
POUGHKEEPSIE NY 12603
11/18/2009
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TAX CODE
CUSTOMER NUMBER
220808
330272990
For Inquires Call: (845) 471-4466
INVOICE TERMS: Payable Upon Receipt
LATE CHARGE: 1-1/2% per Month or Maximum Allowable Rate
Minimum of $.50 Per Month
FED. TAX 10: 23-1689322
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TOWN OF WAPPINGER, NY
20 MIDDLEBUSH RD
WAPPINGERS FALLS NY 12590-4004
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TOWN OF WAPPINGER
ANGIE
20 MIDDLEBUSH RD
WAPPINGERS FALLS NY 12590
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500 CUSTMISC
OPBMISC
125.00
125.00
SAFETY PAPER NO BORDER
) PAY BY CREDIT CARD, SIMPLY CALL YOUR BUSINESS SPECIALIST
TOTAL PRODUCT
DISCOUNT
PREPAYMENT
SHIPPING/HANDLING
SALES TAX
125.00
.00
.00
.00
.00
\FEGUARD MESSAGE:
PLEASE PAY
(845) 471-4466 JEROME MARTIN THIS AMOUNT ~ 125.00
~------------------------------------------------------------------------
TOWN OF WAPPINGER, NY
INVOICE
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~SAr-EGUARD.
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025596730
I
00K9-00
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PLEASE INDICATE CHANGE OF ADDRESS AND/OR PHONE NUMBER:
11/18/2009
E-MAIL ADDRESS:
220808
HV2957
ORDER NUMBER
AMOUNT DUE
~ 125.00
TO INSURE PROPER CREDIT RETURN THIS STUB
WITH YOUR REMITTANCE.
11/18/2009 23:09:26 XXXX
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SAFEGUARD BUSINESS SYSTEMS
PO BOX 88043
CHICAGO IL 60680-1043
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220808 25596730 000012500 1
295015451100
